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Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement

Objectives: To identify barriers and facilitators to engagement when returning to, or participating in, leisure activity post-stroke or Transient Ischemic Attack (TIA). Design: Sequential explanatory, mixed methods study. Setting: 21 hospital sites across England, Wales and Northern Ireland. Partici...

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Autores principales: Harrison, Joanna, Thetford, Clare, Reeves, Matthew J., Brown, Christopher, Joshi, Miland, Watkins, Caroline
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9657985/
https://www.ncbi.nlm.nih.gov/pubmed/36361466
http://dx.doi.org/10.3390/ijerph192114587
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author Harrison, Joanna
Thetford, Clare
Reeves, Matthew J.
Brown, Christopher
Joshi, Miland
Watkins, Caroline
author_facet Harrison, Joanna
Thetford, Clare
Reeves, Matthew J.
Brown, Christopher
Joshi, Miland
Watkins, Caroline
author_sort Harrison, Joanna
collection PubMed
description Objectives: To identify barriers and facilitators to engagement when returning to, or participating in, leisure activity post-stroke or Transient Ischemic Attack (TIA). Design: Sequential explanatory, mixed methods study. Setting: 21 hospital sites across England, Wales and Northern Ireland. Participants: Adults with a clinical diagnosis of first/recurrent stroke or TIA. Patients approaching end of life were excluded. Participants were recruited as in-patients or at first clinic appointment and a baseline questionnaire was completed. A 6-month follow-up questionnaire was sent to participants for self-completion. Open-text questions were asked about barriers and facilitators when returning to, or participating in, leisure activity. Responses were thematically analysed and explored by participant characteristics, including type of leisure activity undertaken. Characteristics also included measures of socioeconomic deprivation, mood, fatigue and disability. Results: 2000 participants returned a 6-month follow-up questionnaire (78% stroke, 22% TIA); 1045 participants responded to a question on barriers and 820 on facilitators. Twelve themes were identified and the proportion of responses were reported (%). Barriers: physical difficulties (69%), lower energy levels (17%), loss of independence (11%), psychological difficulties (10%), hidden disabilities (7%), and delay or lack of healthcare provision (3%). Facilitators: family support (35%), healthcare support (27%), well-being and fitness (22%), friendship support (20%), self-management (19%), and returning to normality (9%). ‘Physical difficulties’ was the most reported barrier across all participant characteristics and activity types. Family support was the most reported facilitator except for those with greater disability, where it was healthcare support and those without fatigue where it was well-being and exercise. Conclusions: Physical difficulties and lack of energy are problematic for stroke and TIA survivors who want to return to or participate in leisure activity. Healthcare support alone cannot overcome all practical and emotional issues related to leisure activity engagement. Family support and improving well-being are important facilitators and future research should explore these mechanisms further.
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spelling pubmed-96579852022-11-15 Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement Harrison, Joanna Thetford, Clare Reeves, Matthew J. Brown, Christopher Joshi, Miland Watkins, Caroline Int J Environ Res Public Health Article Objectives: To identify barriers and facilitators to engagement when returning to, or participating in, leisure activity post-stroke or Transient Ischemic Attack (TIA). Design: Sequential explanatory, mixed methods study. Setting: 21 hospital sites across England, Wales and Northern Ireland. Participants: Adults with a clinical diagnosis of first/recurrent stroke or TIA. Patients approaching end of life were excluded. Participants were recruited as in-patients or at first clinic appointment and a baseline questionnaire was completed. A 6-month follow-up questionnaire was sent to participants for self-completion. Open-text questions were asked about barriers and facilitators when returning to, or participating in, leisure activity. Responses were thematically analysed and explored by participant characteristics, including type of leisure activity undertaken. Characteristics also included measures of socioeconomic deprivation, mood, fatigue and disability. Results: 2000 participants returned a 6-month follow-up questionnaire (78% stroke, 22% TIA); 1045 participants responded to a question on barriers and 820 on facilitators. Twelve themes were identified and the proportion of responses were reported (%). Barriers: physical difficulties (69%), lower energy levels (17%), loss of independence (11%), psychological difficulties (10%), hidden disabilities (7%), and delay or lack of healthcare provision (3%). Facilitators: family support (35%), healthcare support (27%), well-being and fitness (22%), friendship support (20%), self-management (19%), and returning to normality (9%). ‘Physical difficulties’ was the most reported barrier across all participant characteristics and activity types. Family support was the most reported facilitator except for those with greater disability, where it was healthcare support and those without fatigue where it was well-being and exercise. Conclusions: Physical difficulties and lack of energy are problematic for stroke and TIA survivors who want to return to or participate in leisure activity. Healthcare support alone cannot overcome all practical and emotional issues related to leisure activity engagement. Family support and improving well-being are important facilitators and future research should explore these mechanisms further. MDPI 2022-11-07 /pmc/articles/PMC9657985/ /pubmed/36361466 http://dx.doi.org/10.3390/ijerph192114587 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Harrison, Joanna
Thetford, Clare
Reeves, Matthew J.
Brown, Christopher
Joshi, Miland
Watkins, Caroline
Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement
title Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement
title_full Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement
title_fullStr Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement
title_full_unstemmed Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement
title_short Returning to Leisure Activity Post-Stroke: Barriers and Facilitators to Engagement
title_sort returning to leisure activity post-stroke: barriers and facilitators to engagement
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9657985/
https://www.ncbi.nlm.nih.gov/pubmed/36361466
http://dx.doi.org/10.3390/ijerph192114587
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